Newborn circumcision: topical anesthesia is effective painkiller

Healthfacts, Sept, 1993

Traditionally, male infants have been circumcised without anesthesia due to prevailing medical wisdom that newborns feel no pain. Studies published over last decade however, have produced considerable evidence to the contrary, particularly those showing elevated levels of stress hormones in the blood following a painful procedure. Attempts to block pain with local anesthesia have been successful, although the injection itself is painful. A new study from McGill University in Montreal showed that topical anesthesia can effectively decrease pain during circumcision.

Franca Benini, M.D., and colleagues at McGill's Perinatal Research Unit conducted a study of 27 healthy, full-term newborn infants who had been randomly assigned to receive either a topical lidocaine mixture or sterile petroleum jelly (placebo). Following application, each newborn was swaddled and left in a crib for 45 to 60 minutes. The infants were then strapped down, and the procedure was performed. Judging by various physiologic response including heart rate and crying, the topical lidocaine was declared a useful agent for pain management in newborn circumcision."

In the introduction to their study, published last month in JAMA, Dr. Benini and colleagues noted, "The belief that pain is not experienced in the same way by infants, or that it is inconsequential, continues to pervade pediatric practice despite data that infants do experience pain."